Month 60 Outcomes After Treatment Initiation With Anti-Vascular Endothelial Growth Factor Therapy for Macular Edema Due to Central Retinal or Hemiretinal Vein Occlusion

center dot PURPOSE: To investigate 5-year outcomes in eyes initially treated with aflibercept or bevacizumab for macular edema due to central retinal or hemiretinal vein occlusion. center dot METHODS: Long-term follow-up (LTF) after a randomized clinical trial from 64 centers in the United States. Participants were followed up to 60 months and treated at investigator discretion after completing the 12-month treatment protocol. Main outcomes were visual acuity letter score (VALS) and central subfield thickness (CST) on optical coherence tomography. center dot RESULTS: Seventy-five percent (248/330) of eligible participants completed at least 1 visit between months 24 and 60, and 45% completed the month 60 visit. Among participants completing month 60, overall mean VALS improvement over baseline was 13.5 (95% CI: 9.6, 17.5), less than the mean improvement of 20.6 (95% CI: 18.7, 22.4) observed at month 12, with no significant differences between originally assigned study groups. Further, 66% (99/150) had at least 1 treatment between months 48 and 60 with a mean (SD) of 3.41 (3.69) treatments over this period. Mean CST was 671 mu m at baseline and 261 mu m (95% CI: 241.2, 280.9) at month 60. center dot CONCLUSIONS: Although VALS improved substantially when patients were treated per protocol through month 12, improvement lessened when treatment was at investigator discretion and fewer treatments were rebaseline through year 5. Most patients continued to receive treatment in year 5. This suggests that continued

Automated summary

This study investigates the long-term outcomes of using aflibercept or bevacizumab to treat macular edema. The results show that while there is significant improvement in visual acuity and central subfield thickness during the initial treatment period, the improvement lessens when treatment is at the discretion of the investigator. However, most patients continue to receive treatment in the 5-year period.